Developing a Distance Education System to Train Savvy Caregiver Program Interventionists: Extending Access and Capacity in Community-Based Delivery of Evidence-Based Interventions

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This application, submitted in response to RFA-AG-18-030, seeks support for a four-year Stage I intervention development project. We propose to develop a web-based system that uses distance education methods along with manuals and protocols to train, certify, and monitor the performance of interventionists to deliver the Savvy Caregiver program (Savvy), an evidence-based dementia family caregiver psychoeducation program.1 Savvy employs a well-established mechanism of action based in Social Cognitive theory2-5 to promote caregivers' solution-focused coping behaviors through the acquisition of appropriate knowledge, skills, and outlook and the enhancement of caregiving mastery. Well-trained Savvy interventionists who faithfully embrace the program's core principles and its curriculum and are able to adapt program terms, concepts, and even delivery processes to fit the culture and values of caregiver participants are the key to scaling Savvy up to make it widely available to the growing number of dementia family caregivers in the U.S. The proposed system will replace the need for costly – and scarce – in-person interventionist training, and enable organizations – large or small; community-based or statewide – to offer Savvy to their ever more diverse constituents. The system will provide guidelines and materials for administering Savvy, a program to train and certify staff or volunteer interventionists to lead and locally tailor Savvy, and a process by which to monitor the fidelity of interventionists' performance. The training program will prepare interventionists in the core principles and teaching and coaching strategies of Savvy and also prepare them to collaborate with their sponsoring organization and participating caregivers in adapting the terms and concepts of Savvy in ways that are sensitive to and appropriate for the local values and culture of the community. An investigative team of caregiver specialists, educators, and cultural adaptation specialists, supported by a diverse panel of experienced advisors, will undertake a three-phase project, the goal of which is to establish the readiness of the system for a future Stage III or IV trial that can lead the way to broader use and dissemination of Savvy. Using processes employed in prior work that entail iterative development, review, refinement, re-review, and finalization, we will, in Aim 1, develop a prototype web-based system for Savvy interventionist training and certification and an accompanying performance fidelity monitoring process. In Aim 2, we will conduct a formative evaluation of the prototype web-based system. Once the system is deemed ready, we will, in Aim 3, conduct a field test of the system implemented in six culturally and/or organizationally diverse sponsoring agencies. The Aim 3 test will principally assess the effectiveness of the system in training interventionists who maintain fidelity to Savvy core principles but it will also assess the preliminary efficacy of programs led by system-trained interventionists in producing anticipated outcomes in caregiver participants – reduced depression and burden and enhanced caregiving mastery.